HomeMy WebLinkAboutR2020-0888 - Permit ApplicationCITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658 Pii5 4 2020
www.newportbeachca.gov 1 (949)644-3200
RBR # ` XZ - MV
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Application for Report of Residential Building Records ,'op r `" �
Application Fee: $171V00 Notice:
(For All Residential Buildings) Application with insufficient fee payment:
Reinspection Fee $125.00 or incomplete will be returned
Please type or print and complete all information
Number of units: Street Address: 56 Linda Isle
Property Owner: The Taylor Living Trust, established 12/20/04 Zip Code:
Owner Address:
Street City Zip
Home Phone: Work Phone:
Owner's Authorized Agent: PK JENICAN, COLDWELL BANKER REALTY
Agent Address: 31582 S. COAST HWY , LAGUNA BEACH, CA 92651
Work Phone: 949494-0215
Escrow Name and Address: West Coast Escrow, Escrow No. 4530320-09826 - LS
Escrow Address: 31582 S. Coast Highway, Laguna Beach 92651 Escrow Phone: (949)499-4622
Email Report to: TRGWCELagunaBeach@trgc.com
For Inspection Call (Name): Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW)
I authorize inspections and re -inspections of the property listed above. I understand that if Building or Zoning violations
are discovered I will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection Date
OR
Owner/Agent's signature to decline inspection Date
Account #01050504-521040............ Make checks payable to CITY OF NEWPORT BEACH
Who to call for inspection?